Massachusetts’ Waiver Request Could Harm Consumers

By Consumers for Quality Care, on October 2, 2017

The Commonwealth of Massachusetts is asking the federal government to be allowed to make cuts to Medicaid, curtail access to long-term and in-home health care supports, and limit drug coverage. According to Modern Healthcare:

The state has asked for permission to move childless, non-disabled adults with incomes above the federal poverty level into subsidized commercial plans through the state's exchange.

Under the proposal, non-disabled beneficiaries at or below the poverty level would be moved to a version of Massachusetts's Medicaid program that does not cover long-term support and services, such as personal care attendants.

The state also seeks to create a formulary that would limit which drugs the state would have to cover for Medicaid beneficiaries, making the state's program more similar to a commercial insurance plan.

Massachusetts’ announcement has been met with vocal criticisms. A column in Forbes notes that the waiver would “only exacerbate inequalities in health care” and “rations drugs to children and the elderly.” The change would deny consumers access to the most recently approved drugs.

By denying coverage for the newest HIV and cancer medicines approved under the accelerated pathway, Governor Baker is telling Massachusetts’s most vulnerable and poor citizens that they don’t deserve the same access to critical medicines as those patients with private insurance.

Research shows that limiting prescription drugs only yields more negative health outcomes, avoidable death, and can cost the U.S. economy up to $300 billion annually in unnecessary health costs.